Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2020-1161

2. Registrant Information.

Registrant Reference Number: CORT190611

Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.

Address: 24th Floor, 215 2nd Street SW

City: Alberta

Prov / State: Calgary

Country: Canada

Postal Code: T2P 1M4

3. Select the appropriate subform(s) for the incident.

Environment

4. Date registrant was first informed of the incident.

24-JUN-19

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

13-JUN-19

Product Description

7. a) Provide the active ingredient and, if available, the registration number and product name (include all tank mixes). If the product is not registered provide a submission number.

Active(s)

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PMRA Registration No. 31303      PMRA Submission No.       EPA Registration No.

Product Name: Pixxaro A Herbicide

• Active Ingredient(s)
  • FLUROXYPYR 1-METHYLHEPTYL ESTER
  • HALAUXIFEN, PRESENT AS METHYL ESTER

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PMRA Registration No. 28555      PMRA Submission No.       EPA Registration No.

Product Name: Liquid Achieve SC Herbicide

• Active Ingredient(s)
  • TRALKOXYDIM

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PMRA Registration No. 29622      PMRA Submission No.       EPA Registration No.

Product Name: plus M Ester 600

• Active Ingredient(s)
  • MCPA (PRESENT AS ESTERS)

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

10. Site pesticide was applied to (select all that apply).

Site: Res. - Out Home / Rés - à l'ext.maison

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Alleged drift resulting in injury to homeowner's yard. The wind was 18-25 km per hour away from the yard. Applicator dropped his boom and reduced pressure to 20 PSI (lowest possible for equipment). AMS applied accidentally at 3X rate.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

No

Subform IV: Environment (includes plants insects and wildlife)

1. Type of organism affected

Herbaceous Plants / Plante herbacée

2. Common name(s)

Tomatoes and garden plants

3. Scientific name(s)

Unknown

4. Number of organisms affected

Unknown

5. Description of site where incident was observed

Fresh water

Terrestrial

Residential

Salt Water

6. Check all symptoms that apply

Deformities

Epinasty (leaf wilt)

7. Describe symptoms and outcome (died, recovered, etc.).

Applicator sprayed on June 11, 2019. Property owners noticed a strong odor June 13th. Property owner noticed injury to weeds, garden plants in yard and greenhouse tomatoes.

8. a) Was the incident a result of (select all that apply)

Application

Drift

N/A

8. b) i) How many times has the product been applied this year?

Unknown

8. b) ii) What was the date of the last application?

11-JUN-19

9. Did it rain

9. a) During application?

No

9. b) Up to 3 days after application?

Unknown

10. a) Was there a buffer zone?

Unknown

10. b) What type?

10. c) What was the size of the buffer zone?

11. a) Were environmental samples collected and analysed?

No

To be determined by Registrant

12. Severity classification (if there is more than one possible classification, select the most severe)

Minor

13. Please provide supplemental information here